Pharmacy World and Science

, Volume 27, Issue 2, pp 76–80 | Cite as

Rational use of medicines – an important issue in pharmaceutical policy

  • Anna Birna AlmarsdóttirEmail author
  • Janine M. Traulsen


In this article the authors deal with issues of drug utilisation from a clinical and policy perspective. They address the difficulties of managing drug therapy on a population level, which is known among professionals, as the problem of rational use of medicines. Various definitions and interpretations are presented and compared. This is followed by a presentation of the concerns associated with pharmaceutical marketing from a policy perspective, including the fear that the dominance of information produced by industry may lead to irrational drug use. Next, the authors review the tools for policy making including educational, managerial, and regulatory interventions. The (often overlapping) concepts of medicines management, clinical pharmacy and pharmaceutical care are then discussed to show how professionals, sometimes in collaboration with policymakers, have tackled the problem of nonrational use of medicines. The authors address the question as to whether the rational use of medicines a universal concept, whether it can be and whether it should be? They argue that, as with most concepts, the rational use of medicines must always be viewed in context. They conclude that pharmacy needs to adapt its way of thinking to include the issue of context. They point out that clinical pharmacists today already adapt their decisons to each patient and patient group. Policymakers are encouraged to adopt a similar approach because populations as well as particular market situations vary and therefore policy solutions cannot be considered universal.


Clinical pharmacy Drug utilisation Medicine management Pharmaceutical care Pharmaceutical policy Rational medicine use 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Jary, D, Jary, J. 1991Collins Dictionary of SociologyHarper Collins PublishersGlasgowISBN 0 00434359 XGoogle Scholar
  2. World Health Organization2001How to develop and implement a national drug policy2World Health OrganizationGeneva5968ISBN 92 4 154547 XGoogle Scholar
  3. Loewenstein, G. 2004Doctors and drug companiesN Engl J Med.351188590CrossRefPubMedGoogle Scholar
  4. Spiller, LD, Wymer, WW. 2001Physicians’ perceptions and uses of commercial drug information sources: an examination of pharmaceutical marketing to physiciansHealth Mark Q.1991106CrossRefPubMedGoogle Scholar
  5. Armstrong, D, Reyburn, H, Jones, R. 1996A study of general practitioners’ reasons for changing their prescribing behaviourBMJ.31294952PubMedGoogle Scholar
  6. Jones, MI, Greenfield, SM, Bradley, CP. 2001Prescribing new drugs: qualitative study of influences on consultants and general practitionersBMJ.32337881CrossRefPubMedGoogle Scholar
  7. Avorn, J, Chen, M, Hartley, R. 1982Scientific versus commercial sources of influence on the prescribing behavior of physiciansAm J Med.198248CrossRefGoogle Scholar
  8. Wazana, A. 2000Physicians and the pharmaceutical industry: is a gift ever just a gift?JAMA.28337380CrossRefPubMedGoogle Scholar
  9. Mintzes, B, Barer, ML, Kravitz, RL, Bassett, K, Lexchin, J, Kazanjian, A, Evans, RG, Pan, R, Marion, SA. 2003How does direct-to-consumer advertising (DTCA) affect prescribing? A survey in primary care environments with and without legal DTCACMAJ.16940512PubMedGoogle Scholar
  10. Kaiser Family Foundation. National Survey of Physicians Part II: Doctors and Prescription Drugs, 2002. Scholar
  11. Kaiser Family Foundation. Understanding the Effects of Direct-to-Consumer Prescription Drug Advertising, 2001. Scholar
  12. Anon. Medicines management services – why are they so important? MeReC Bulletin (National Prescribing Centre NHS) 2002; 12(6)Google Scholar
  13. The Audit Commission. A Spoonful of Sugar – Medicines Management in NHS Hospitals. London: The Audit Commission, 2001. nrspoonfulsugar.pdfGoogle Scholar
  14. Barber, N. 2001Pharmaceutical care and medicines management – is there a difference?Pharm World Sci.2321011CrossRefPubMedGoogle Scholar
  15. ESCP. What is clinical pharmacy? (accessed 22 November 2004)Google Scholar
  16. ACCP. Defining Clinical Pharmacy. The ACCP Report 23(2). February 2004. 01.phpGoogle Scholar
  17. Mikeal, RL, Brown, TP, Lazarus, HL, Vinson, MC. 1975Quality of pharmaceutical care in hospitalsAm J Hosp Pharm.356774Google Scholar
  18. Brodie, DC, Parish, PA, Poston, JW. 1980Societal needs for drugs and drug-related servicesAm J Pharm Educ.4427678PubMedGoogle Scholar
  19. Hepler, CD, Strand, LM. 1990Opportunities and responsibilities in pharmaceutical careAm J Hosp Pharm.4753343PubMedGoogle Scholar
  20. Cipolle, RJ, Strand, LM, Morley, PC. 2004Pharmaceutical care practice – the clinician’s guide2McGraw-HillNew YorkGoogle Scholar
  21. van Mil JWF. Pharmaceutical care – the future of pharmacy. Thesis, Chapter 1. Rijksuniveriteit Groningen, 1998Google Scholar
  22. Munroe WP, Dalmady-Israel C. (1998). The community pharmacist’s role in disease management and managed care. Int Pharm J. 12(Suppl II)Google Scholar
  23. Rioux, PP. 2000Clinical trials in pharmacogenetics and pharmacogenomics: methods and applicationsAm J Health Syst Pharm.57887901PubMedGoogle Scholar
  24. March, R. 2000Pharmacogenomics: the genomics of drug responseYeast.171621CrossRefPubMedGoogle Scholar
  25. Condit, C, Templeton, A, Bates, BR, Bevan, JL, Harris, TM. 2003Attitudinal barriers to delivery of race-targeted pharmacogenomics among informed lay personsGenet Med.538592PubMedGoogle Scholar
  26. Almarsdóttir, AB, Björnsdóttir, I, Traulsen, JM. 2005A lay prescription for tailor-made drugs – focus group reflections on pharmacogenomicsHealth Policy.7123341CrossRefPubMedGoogle Scholar
  27. Lichtenberg, F. 1996Do (more and better) drugs keep people out of hospitals?Am Econ Rev.863848ABI/INFORM GlobalPubMedGoogle Scholar
  28. Cutler, DM, McClellan, M. 2001Is technological change in medicine worth it?Health Aff.201130Google Scholar
  29. Ragnarson Tennvall, G, Karlson, G. 1998Cancer treatment in Sweden – costs of drugs, inpatient and outpatient care from 1985 to 1996 and cost effectiveness of new drugsActa Oncol.3744753CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Anna Birna Almarsdóttir
    • 1
    Email author
  • Janine M. Traulsen
    • 2
  1. 1.Faculty of Pharmacy, AL-BAS Pharmaceutical Consultants Ltd.University of IcelandReykjavíkIceland
  2. 2.Department of Social PharmacyThe Danish University of Pharmaceutical SciencesCopenhagen ØDenmark

Personalised recommendations